Investigators say the doctor was profiting off his prescription pad, selling his signature to addicts and dealers for up to $500 per prescription.

Watson’s case, which is set to go to trial this week, and several other recent cases offer a peek into the business of “pill shopping” and reflect the relative ease in getting prescription narcotics from legitimate providers. While some users can obtain prescriptions with a wink and a nod, authorities say, others try to fool several unsuspecting doctors with pleas for pills, a practice known as “doctor shopping.”

Prescription drug fraud cases are up this year, with the U.S. Drug Enforcement Administration in San Diego involved in some 100 arrests as the fiscal year draws to a close Sept. 30. That’s up from about 60 the previous year, according to DEA Supervisory Special Agent Thomas Lenox, who heads the local squad dedicated to prescription abuse. Most of those cases involve doctor shopping, stolen prescriptions, impersonation of medical professionals or pill smuggling.

“I had hoped by now this would be something over my 28-year career I’d be able to see some sign of progress or change,” Lenox said. “Unfortunately, it’s been very slow.”

Last week, the DEA took a step that might help. It tightened controls on painkillers containing hydrocodone — considered to be the most abused prescription drug in the nation — by reclassifying them as Schedule II narcotics. In practical terms, it means prescriptions for drugs such as Vicodin and Norco can no longer be phoned into pharmacies, but must be presented in original paper form, thus reducing the potential for impersonators.

The medical community in San Diego is also stepping up its role policing itself in response to the high number of unintentional deaths related to prescription drugs. The Medical Examiner’s Office counted 259 such fatalities in the county last year.

A consortium of physicians, psychiatrists, dentists, hospital administrators, county health providers and pharmacists formed a task force last year that gave local medical professionals new guidelines on dispensing highly-abused drugs, and is backing the continued expansion of a state database that tracks such prescriptions.

That database, the Controlled Substance Utilization Review and Evaluation System, with the appropriate acronym of CURES, requires pharmacists to log most controlled substances dispensed to a patient, along with the doctor who wrote the prescription. Doctors are also encouraged to sign up for access and check for suspicious patterns before writing prescriptions for certain drugs.

The system has been slow to catch on, and has had technical setbacks, but health care providers have placed a renewed emphasis on the system and have agreed to help pay for technological improvements to be in place by 2016.

It was the CURES system that showed a troubling pattern in Dr. Watson’s practice, according to court records. The logs showed many young patients being prescribed the same oft-abused drugs — hydrocodone, oxycodone and Xanax, according to court records. The report showed that after OxyContin’s makers reformulated the 80 mg dosage to prevent abuse by making it impossible to smoke, crush or snort, Watson reverted to prescribing the 30 mg version, which lacked the safeguards. The data backed up what confidential sources had been reporting to authorities as early as 2009.

So the DEA put recording devices on some “patients” and sent them to Watson for a visit.

One confidential source complained of cracking a rib while surfing and asked for more pills to supplement the hydrocodone he’d already been given in urgent care.

“It’s not quite enough?” Watson asked. Then, without asking for further information or consulting medical records, Watson wrote a prescription for 120 oxycodone tablets, according to court records. The surfer paid him $165.

Watson was chatty during the visit, telling the surfer the DEA was “on (his) back” for “prescribing a few too many medicines for a few patients.” He further bragged that he’d given 150 Norcos to a lawyer each week, even though that much painkiller was “likely to kill someone,” he said.

The surfer then introduced a woman as his girlfriend, who was actually an undercover agent.

The agent told the doctor said she had hurt her knee in a car accident several years ago and it gave her occasional trouble. When Watson said he heard she needed “treatment,” he winked, and ultimately dashed off a prescription for 120 oxycodone and 30 Xanax for $170, the records say. Never during the appointment did he take her medical history, review past files or recommend other remedies, according to the court documents.

Investigators tracked down others who’d allegedly bought from Watson, with one admitting he turned around and sold the pills for $20 on the street. One suspected dealer gave Watson a prepaid cellphone to coordinate the sales, which were done not only in his office, but at Starbucks and Kinkos, court records say.

A second person told investigators Watson accepted payment in the form of stolen luxury handbags and fine wine for prescriptions. The buyer then exchanged the pills for heroin from a street dealer, the records state.

“I got paid $165 if I didn’t write a script, and $500 if I did write the script,” Watson is recorded telling one patient, using the shorthand term for prescription.

He was arrested June 4, 2013. A federal grand jury later indicted him on 41 counts — representing 41 transactions from March 2011 to August 2012. His medical license was suspended.

His attorney has argued in court filings that Watson suffers from severe bi-polar disease, and episodes of delusions may have caused him to act with negligence or by mistake, but not with criminal intent. His trial is set to begin in San Diego federal court on Tuesday.

A Hillcrest pharmacist lost her business recently over allegations of failing to account for 16,000 missing oxycodone pills, dispensing drugs with invalid or nonexistent prescriptions, exchanging drugs for services or advancing pills to customers, according to the U.S. Attorney’s Office.

In June, Alma Loechler agreed to pay a $147,500 civil settlement with the federal government, as well as sell Sixth Avenue Pharmacy and give up her license to sell DEA controlled substances.

Lenox, the DEA supervisor, said cases of corrupt doctors and pharmacists are rare, typically showing up in one to two investigations a year.

A long-running task force investigation led to husband and wife Bryce (left) and Jenneifer (right) Charpentier, San Diego police officers, who were arraigned on suspicion of drug sales, drug possession and drug transportation. They pleaded not guilty.

Photo by Louie Juarez

A long-running task force investigation led to husband and wife Bryce (left) and Jenneifer (right) Charpentier, San Diego police officers, who were arraigned on suspicion of drug sales, drug possession and drug transportation. They pleaded not guilty.

A long-running task force investigation led to husband and wife Bryce (left) and Jenneifer (right) Charpentier, San Diego police officers, who were arraigned on suspicion of drug sales, drug possession and drug transportation. They pleaded not guilty. (Photo by Louie Juarez)

What’s much more common are users and dealers who shop around to multiple doctors and pharmacies, making medical professionals oftentimes unwitting accomplices.

It’s how a married pair of San Diego police officers, Bryce and Jennifer Charpentier, are accused of obtaining their drugs. Authorities got tipped to the couple after an informant in a long-term drug investigation said they were a source for prescription pills, according to a search warrant filed in San Diego Superior Court.

The warrant says the CURES database showed Jennifer Charpentier filled 71 prescriptions from seven doctors over the past two years, and her husband obtained 79 prescriptions from six doctors. Authorities executed search warrants at the offices of 12 local doctors, seeking records of the Charpentiers’ visits.

The officers were arrested June 5 and have entered not guilty pleas.

Such cases reaffirm the need for medical professionals to work together on the issue, said Dr. Roneet Lev, who chairs the San Diego Prescription Drug Medical Task Force. The wide-ranging group of health care providers in the county have agreed to follow stricter guidelines, including making sure chronic pain patients are treated by a single doctor and a single pharmacy and dispensing only a small amount of drugs in emergency rooms, telling patients to get follow-up care from their primary doctors.

Lev is helping establish similar task forces across the state.

“This is a societal problem and the medical community plays a piece,” said Lev, the director of operations of the emergency department at Scripps Mercy Hospital. “Medications are very helpful but they can become a poison when not taken correctly.”

It’s a poison that sometimes even doctors themselves can’t resist. State medical board records show several physicians across Southern California have been disciplined in connection with drug abuse. La Jolla’s Dr. Bradley Schnierow, a sleep disorder expert, is accused of writing 73 fraudulent prescriptions for drugs to his girlfriend, while falling into drug abuse himself.

He was evicted from his medical office in May for not paying rent. His increasingly erratic behavior included not showing up for appointments with patients, according to court records. A DEA search of his home found numerous drugs and drug paraphernalia, and a search at his girlfriend’s home turned up 10 blank prescription forms, court filings show.

He pleaded not guilty in July to several drug-related charges. His medical license has been suspended.

Lenox said doctor drug abuse is one of the squad’s highest priorities, because doctors under the influence could put patients’ lives in jeopardy. The danger doesn’t end there.

“People are driving on our roads under the influence of prescription drugs, going to work everyday under the influence of prescription drugs, endangering our community,” Lenox said. “We need to make sure we continue to make this a priority.”